DETERMINATION OF ADENOSINE MONOPHOSPHATE-ACTIVATED PROTEIN KINASE AND CHEMERIN LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND GOUTY ARTHRITIS AS PROGNOSTIC MARKERS OF CARBOHYDRATE METABOLISM DISORDERS
DOI:
https://doi.org/10.21856/j-PEP.2023.4.03Keywords:
AMPK, chemerin, gout, insulin resistance, diabetes mellitus type 2, carbohydrate metabolismAbstract
Background. Type 2 diabetes mellitus (T2DM) is a multifactorial epigenetic disease that is widespread in the world. The combination of gouty arthritis and T2DM has been found to be quite common. Studies have shown that hyperuricemia increases insulin resistance and suppresses the effects of insulin, which is a pathogenetic pathway for the development of T2DM, so studying the biochemical relationships between purine and carbohydrate metabolism is necessary. Adenosine monophosphate-activated protein kinase (AMPK) and chemerin were selected for evaluation as markers reflecting the state of carbohydrate metabolism in patients with type 2 diabetes and gouty arthritis.
Purpose: analysis of AMPK and chemerin levels, and determination of their correlational relationships with indicators of carbohydrate metabolism in patients with type 2 diabetes and gouty arthritis.
Materials and methods: 100 patients of both sexes participated in the study, who were divided into 2 groups: group 1 – patients with gouty arthritis and T2DM, n=70; group 2 – patients with a mono-course of gouty arthritis, n=30. Control group – 20 relatively healthy individuals. The levels of serum chemerin, AMPK, fasting blood glucose, glycated hemoglobin, and insulin were assessed in all patients according to generally accepted methods; the HOMA-IR index was calculated mathematically. Pearson's linear correlation coefficient (r) and ANOVA were used for statistical analysis.
Results: The lowest levels of AMPK (8.56±4.01 ng/ml) were obtained in patients of the 1st group as compared to the 2nd group (21.93±4.87 ng/ml, p1,2<0.0001) and the control group (26.37±5.56, p1,c<0.0001). Significantly higher levels of chemerin were obtained among patients of the 1st group (12.51±3.92) and the 2nd group (9.86±2.66) as compared to the control group (3.41±1.42, p<0.0001). In the case of a comorbid combination of T2DM and gouty arthritis, probable correlation relationships of mostly medium strength were noted between indicators of AMRK (inverse), chemerin (direct) and carbohydrate metabolism among the examined patients.
Conclusions. The identified correlations between AMPK, chemerin and carbohydrate metabolism parameters, allow us to state that the abovementioned markers play a pathogenetic role and have diagnostic and prognostic significance for detecting insulin resistance in patients with gouty arthritis and assessing the severity of type 2 diabetes in patients with comorbid pathology.
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